Provider Demographics
NPI:1447279658
Name:CITY OF ALEXANDRIA
Entity type:Organization
Organization Name:CITY OF ALEXANDRIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-746-3400
Mailing Address - Street 1:4850 MARK CENTER DR FL 8
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1882
Mailing Address - Country:US
Mailing Address - Phone:703-746-3400
Mailing Address - Fax:
Practice Address - Street 1:4850 MARK CENTER DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1882
Practice Address - Country:US
Practice Address - Phone:703-746-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF ALEXANDRIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-19
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945026Medicaid
VAA439OtherBLUE CROSS BLUE SHIELD
VA18023OtherANTHEM HEALTHKEEPERS MCO
VA18023OtherANTHEM HEALTHKEEPERS MCO